Billing Representative

Full Time
Scottsdale, AZ
Posted 1 month ago

Job Description:

The Billing Representative is responsible for the accurate and timely billing of ambulance transports, while maintaining the quality and productivity standards set for the Coding Representative.   The incumbent is expected to determine diagnosis and levels of service based on information provided on the Patient Care Report (PCR) and to accurately bill, using the appropriate codes.

Responsibilities:

  • Review and/or determine the appropriate primary source of payment
  • Determine the appropriate Level of Service to be billed, based on supporting documentation on the PCR and/or in the Computer Aided Dispatch (CAD) notes, including but not limited to, designating Advanced Life Support (ALS), Basic Life Support (BLS), or Specialty Care Transport (SCT)/Critical Care Transport (CCT)
  • Update and add insurance coverage to the Accounts Receivable Billing System after verification of benefits
  • Assign proper condition codes, procedure codes, primary and secondary modifiers and identify excessive mileage
  • Create narrative in the Accounts Receivable Billing System to document status of trip
  • Assign ancillary procedures to charges when applicable, based on payor-specific guidelines, (e.g. IV treatment and oxygen)
  • Make outbound calls as needed to obtain additional information on insurance coverage, patient demographics, and/or to verify inpatient or Part A status
  • Run “Journal Entry” report daily to verify accuracy of data entered
  • Verify that a Physician Certification Statement or a Letter of Medical Necessity has been received and contains the required information/signatures
  • Forward to appropriate “Collection Plan” and request additional information on claims that do not have the required Physician Certification or a Letter of Medical Necessity and apply appropriate trip status and collection plan
  • Adhere to all company policies and procedures

Requirements:

  • High School Diploma or GED
  • 0-2 years experience in data entry
  • Previous experience in a healthcare setting strongly preferred
  • Demonstrated familiarity with medical terminology and services.
  • Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet
  • Medical terminology and insurance terminology
  • Process of signature and paperwork compliance
  • Knowledge of HIPAA requirements
  • Proficiency in the Accounts Receivable Billing System and Internet tools, (e.g. Internet mapping programs, eligibility websites, address search engines)
  • Computer literacy / 35 WPM
  • Communicate effectively, (both orally and in writing) in English

Benefits:

Integra Connect, LLC provides a comprehensive benefits plan.

  • Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
  • 401k with employer match
  • Paid Time Off
  • Paid Holidays and Floating Holiday
  • Equal Opportunity Employer

Equal Opportunity Employer

Job Features

Job CategoryBilling Administration

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